The inflammatory process of the bladder in most cases is recorded in men over 40 years old, which is associated with a natural decrease in immunity. Men who have concomitant pathologies of the genitourinary system of an infectious nature are predisposed to the development of cystitis.
Cystitis is a rare disease in men. Thanks to the elongated urethra, it is difficult for infection to enter the bladder. A stream of urine eliminates the pathogen that has entered the urethra, but if it manages to linger on the walls of the urethra, the movement through it is so slow that the cells of the systemimmune system have time to kill the infectious agent.
This explains why the diagnosis of pathology in men is 10 times less frequent than in women. The disease develops only if there are factors favoring the massive development of pathogenic microflora against the background of a pronounced decrease in immunity. These conditions often create bladder congestion.
Causes of cystitis in men
The disease develops when E. coli, coccal or urogenital infections enter the bladder. This process is facilitated by changes such as:
- decrease in immunity under the influence of radiation, development of diabetes mellitus, blood diseases;
- development of a negative response of the immune system;
- inflammatory process in the prostate, kidneys, ureters;
- bladder compression due to prostate cancer or benign hyperplasia;
- formation of fistulas in the rectum;
- sepsis;
- bodily harm caused by sexually transmitted infections;
- reverse urine flow;
- bladder injury, especially following surgical procedures in the pelvic region;
- penetration of protozoan viruses into the blood and lymph.
Prolonged hypothermia of the body, which causes a sharp decrease in immunity, can also provoke the development of pathology.
Types of cystitis
Depending on how the symptoms manifest, the disease is divided into acute and chronic forms. Acute cystitis is usually divided into those that occur for the first time, appear no more than once a year, or are recorded at least twice a year. After completion of all therapeutic measures, no inflammatory processes are detected in the bladder, and a control laboratory test confirms the normalization of all indicators.
When prescribing treatment, changes are made to the standard treatment regimen taking into account the primary or secondary nature of the disease. Primary cystitis occurs independently and is not a complication of another pathology. An acute form of pathology can occur as a result of exposure to a medicinal, toxic, infectious or chemical factor. Parasitic infection can also cause pathology. The chronic form can be infectious, traumatic, neurotrophic or radiation-induced.
Chronic cystitis is characterized by a course during which periods of rest are replaced by exacerbations. There are 3 types of chronic form:
- Latent.The disease occurs without the appearance of pronounced symptoms and is detected during a routine medical examination. The pathology presents rare periods of exacerbations, the symptoms of which coincide with acute cystitis.
- Persistent.The exacerbation is recorded about 2 times a year. The symptoms of the disease are moderate.
- Interstitial.This form is characterized by frequent exacerbations and the presence of pain even during periods of rest. This cystitis is considered the most dangerous and difficult to treat type of cystitis, causing rapidly progressive destruction of the bladder walls.
In most cases, when classifying a chronic disease, the urologist focuses on the severity of damage to the organ wall, the severity of symptoms, and not the frequency of relapses.
In medical practice, a classification is also used that allows the pathology to be subdivided according to the criterion of the affected part of the bladder. In this case, it is customary to distinguish cystitis:
- Cervical.The inflammatory process is localized in the neck of the bladder, affecting its sphincters. A man faces the problem of frequent urination and urinary incontinence. The process of emptying the bladder itself becomes painful.
- Trigonite.The inflammatory process begins from the sphincter of the affected organ and spreads to the mouth of the ureter. This form often causes the development of urinary reflux. When urine flows backwards, the infectious agent is able to penetrate the kidneys, thereby contributing to the development of pyelonephritis. The man suffers from urinary problems, including incontinence of urine containing blood or pus.
- Broadcast.Its particularity is the damage to the wall of the bladder.
When identifying damage to the mucous membrane and structures located under it, the urologist is not enough to diagnose diffuse cystitis, he must also clarify the subtype of the disease, which characterizes the features of the courseof the inflammatory process and the damage caused. by this.
To determine the characteristics of damage to the walls of the bladder during cystitis, methods of endoscopic examination using biopsy are used. The study of biological material and analysis of the accompanying symptoms allows us to further classify the pathology as:
- catarrhal, which only causes redness and irritation of the mucous membrane;
- hemorrhagic, causing the development of bleeding;
- cystic, in which cysts form on the damaged wall;
- ulcerative, whose name is due to the appearance of ulcers;
- phlegmonous, diagnosed when pus forms in the problem area;
- gangrenous, recorded in the presence of tissue necrosis.
There are also some types of diseases that are extremely rarely recorded, for example, urogenital schistosomiasis or caused by fungal infection. The inflammatory process can be accompanied by the appearance of a large number of plaques on the mucous membrane of the organ; in this case, cystitis is defined as malacoplakia.
Characteristic symptoms of cystitis in men
Signs of pathology may vary slightly depending on whether it presents in an acute or chronic form, the type of pathogen and the nature of the lesion. The severity of the disease is determined by the intensity of symptoms and the degree of bladder damage.
Acute cystitis is characterized by impaired urination, which becomes painful and difficult, with frequent urges, including at night. Patients often complain of a false urge to urinate and a feeling of incomplete emptying of the bladder. The urine itself becomes dark and cloudy, may acquire a specific pungent odor or contain impurities of pus or blood.
The inflammatory process in most cases causes an increase in body temperature and the appearance of severe pain localized in the groin, scrotum and urethra. Intoxication of the body leads to general weakness, lethargy and decreased concentration. In some forms of pathology, urinary incontinence is recorded. With a long course of the disease, urination begins to be accompanied by a pronounced burning sensation.
In the chronic form of the disease, the intensity of symptoms is less pronounced and high temperatures are rarely recorded. In case of latent cystitis, signs of pathology may be completely absent, the presence of an inflammatory process can only be detected by laboratory tests.
Interstitial cystitis is accompanied by a significant increase in the urge to urinate, accompanied by persistent and constant pain in the suprapubic region. General changes in the body boil down to the development of anxiety, irritability and progressive depression.
Diagnosis of cystitis
Establishing a diagnosis requires a visit to a urologist, who conducts a personal examination of the patient and studies a series of complaints. The patient should undergo a rectal examination. The doctor inserts a finger into the rectum to examine the condition of the prostate. This method allows you to determine whether the symptoms are associated with prostatitis or prostatic hyperplasia.
The next step is a referral to laboratory tests, which will not only confirm the presence of an inflammatory process, but also determine the type of infectious agent in order to select a drug to which it will have maximum sensitivity. The list of laboratory tests includes:
- General urine analysis.The development of cystitis is indicated by an increased concentration of leukocytes, the presence of mucus, bacteria, epithelial cells or blood impurities in the biological fluid.
- General blood analysis.Changes in indicators indicate the severity of the pathology. This list includes the detection of leukocytosis, an increased concentration of eosinophils.
- Seedling tankThe study of pathogens contained in urine or on the walls of the urethra makes it possible to assess their sensitivity to the action of various antibacterial drugs.
- Infection screeningsexually transmitted diseases.
If the results obtained give a blurred picture, not allowing to unambiguously determine the patient's condition, it is possible to prescribe additional studies, including a biochemical blood test, immunogram and assessment of the concentration of specific antigen ofprostate.
Additionally, during a comprehensive examination, instrumental diagnostic methods are used:
- cystography and cystoscopy;
- Ultrasound of kidneys, prostate;
- uroflowmetry.
Ultrasound of the bladder can give the most detailed picture of the condition of the bladder, but during the acute course of the pathology, it is impossible to fill the organ with urine to the limitrequired, which precludes the use of this method.
Treatment of cystitis in men
The therapeutic course should only be prescribed by a doctor. For mild or moderate forms of pathology, outpatient treatment is possible, which includes regular follow-up examinations by a urologist. In severe cases of acute urinary retention, pain or severe bleeding, hospital treatment is prescribed.
Surgical treatment is rarely used; the indication for surgery is acute urinary retention in the presence of tissue necrosis or prostate adenoma. In other cases, conservative therapeutic methods are used.
When diagnosing acute cystitis, a man is recommended to stay in bed for 3-5 days. He must follow a diet that excludes from the diet foods or drinks that irritate the walls of the bladder:
- alcohol;
- strong tea, coffee;
- salty or smoked foods;
- hot spices.
The patient should increase the volume of fluid consumed to 3 liters per day, while avoiding carbonated drinks and energy drinks. To suppress the inflammatory process, the patient is prescribed a complex of antibacterial drugs, antiseptics and antispasmodics. Additionally, herbal decoctions with a pronounced mild anti-inflammatory and antiseptic effect, for example, based on chamomile and calendula, can be used.
To combat moderate pain, you can additionally use a heating pad on the lower abdomen, but for hemorrhagic or tuberculous forms of the pathology, this method is contraindicated. Anesthetic microenemas can relieve acute pain, but they can only be used with the permission of the attending physician. The duration of treatment for acute cystitis rarely exceeds 14 days.
Treatment of chronic cystitis involves taking measures to eliminate factors that support and provoke the inflammatory process. In the presence of congestion, massages and appropriate medications are prescribed; if stones or prostatitis are detected, measures are taken to get rid of them. After determining the sensitivity of the pathogen, antibiotic therapy is selected.
Chronic cystitis is treated not only with medication, but also with physical therapy. The second group includes the insertion of a catheter into the bladder for flushing with an antibacterial or antiseptic solution, for example based on sea buckthorn oil. Additionally, electrophoresis, mud therapy and inductothermy are used.
For tuberculous cystitis, drugs capable of suppressing the activity of the pathogen and instillations based on fish oil are prescribed.
In the treatment of the radiological form of pathology, instillations of regenerating agents are also used, but in case of extensive lesions, plastic surgery is recommended. For the treatment of interstitial cystitis, a complex of drugs is prescribed, including pain relievers, hormones, antimicrobials, anti-inflammatories and antihistamines.
Herbal decoctions are used as auxiliary treatment. To prepare herbal tea, dried flowers or leaves of chamomile, St. John's wort, nettle and eucalyptus can be used. These agents act gently, do not have a pronounced effect on the immune system and stimulate the body's natural protective functions. The duration of treatment can reach 1 year, while the herbal mixture should be changed every 2 months.
Complications of the disease
If you do not consult a doctor in time, there is a risk of infection penetrating the kidneys, which provokes the development of pyelonephritis or reverse urine flow. In some forms of pathology, the formation of a fistula can become a complication. Damage to the bladder sphincter does not always contribute to urinary incontinence and the development of acute retention is also possible.
Cystitis prevention
The development of the disease can be avoided by maintaining intimate relationships, including preventing sexually transmitted infections. A man needs to monitor the general state of his immunity, which requires timely treatment of all infectious diseases, fight against prostatitis and annual medical examinations. Quitting smoking, leading an active lifestyle, and avoiding hypothermia can help prevent cystitis.
Cystitis in men is rarely diagnosed, but this does not mean that the pathology is harmless. With reduced immunity and changes occurring in the body due to natural aging (after 40 years), the risk of developing pathology increases significantly.
It should be borne in mind that the disease can be asymptomatic for some time, so men should not refuse preventive medical examinations that allow you to detect inflammation at an early stage.